Can the law silence the person you trust most?

In Philippine society, family is not always defined by blood. Yet during medical emergencies, legal authority in healthcare decision-making still heavily depends on traditional kinship, leaving many partners without a voice.

This critical gap led to the creation of the Right to Care (RTC) program. The initiative was designed to bridge the long-standing divide between medical protocols and non-blood relationships — particularly those who belong to the LGBTQIA+ community, whose partners lack the legal recognition required to make urgent medical decisions for their significant others.

They have embraced what was once oppressed

According to Quezon City Mayor Joy Belmonte, the RTC program will provide a safeguard for individuals when hospitals defer to biological relatives, even when those relatives have had little to no involvement in the patient’s life.

“Sometimes, family members have abandoned them because of their sexual orientation or gender identity, yet those same relatives are the ones consulted during emergencies,” Belmonte said. “The partner, who knows their wishes best, is often denied the right to decide.”

Since its launch in Quezon City, multiple cities have adopted similar programs, creating momentum across the country. These cities are: 

• San Juan
• IloIlo 
• Parañaque 
• Dasmariñas
• Mandaluyong 

Meanwhile, the provinces of Cebu and Cavite have implemented the program at the provincial level. This growing adoption in multiple cities and provinces has piqued the interest at the national legislature level, providing a possibility of a wider adoption of the program at a country level and the passage of more inclusive statutory laws.

Akbayan Representative Perci Cendaña, who helped develop the original ordinance in Quezon City, recently filed the proposed Right to Care Act in Congress to extend the program nationwide. The bill would allow individuals to formally assign a trusted healthcare proxy  to make medical decisions on their behalf in case of medical emergencies or in terms of medical care without the need for prior consent from a biological relative.

The push has also gained traction in the Senate, where Senator Risa Hontiveros proposed the Healthcare Proxy Act, which similarly recognizes a patient’s right to appoint a non-blood representative.

“Every Filipino hopes that if the time comes that they are sick, weak, or unable to speak for themselves, someone they trust will be there to speak for them,” Hontiveros stated. “But today, for many Filipinos, that assurance does not yet exist in law.” 

Senator Hontiveros’ statement underscores a reality already experienced by countless Filipinos whose chosen support systems are ignored by the state. In medical decisions, this can leave longtime partners, close friends, or chosen family members unable to participate in important healthcare discussions, despite being the individuals most familiar with the patient’s daily needs and wishes.

For the advocates, the spread of local RTC ordinances serves as proof that the policy works. “It shows there is already a successful model in different local governments,” Cendaña argued, emphasizing that national legislation would ensure Filipinos would have equal access to these healthcare protections, regardless of where they live.

Why should the program matter? 

The Right to Care program addresses a fundamental, unresolved question in the Philippine health care system: Who gets to decide when a patient cannot speak for themselves? 

While developed in response to the historical exclusion of LGBTQIA+ couples,  the initiative reflects a broader societal shift toward recognizing “chosen families.”

Beyond aiding LGBTQIA+ community, the measure can provide practical protections for unmarried couples, solo parents, overseas Filipino workers (OFWs), and persons with disabilities (PWDs). By utilizing healthcare proxies and existing legal tools like the Special Power of Attorney (SPA)—rather than attempting to rewrite the rigid National Family Code—the policy offers a pragmatic, urgent solution that can navigate the country’s conservative political landscape

By formalizing the designation of a healthcare proxy, the Act aims to provide clear guidance during high-stress medical emergencies. Currently, in the absence of a legally recognized representative, medical providers are legally obligated to locate a biological relative to:

• consent to surgical or medical procedures
• access medical information,
• make critical end-of-life decisions. 

Allowing individuals to appoint their own representative establishes a clear chain of authority, reducing bureaucratic delays and ensuring a patient’s dignity and wishes are upheld in critical moments. 

Behind ‘Right to Care Program’

The debate surrounding the Right to Care Act extends far beyond hospital administrative procedures; it challenges the state’s rigid definition of kinship. Historically, both the Family Code and the Civil Code of the Philippines have prioritized biological relatives and legally wedded spouses, reflecting a deeply institutionalized, family-centered culture.

However, contemporary realities clash with these laws. Many Filipinos, including LGBTQIA+ couples, rely on partners and chosen family members as primary caregivers, but the law only recognizes biological relatives and legally recognized spouses.

Whether or not legislators approve the national bill, the public discourse has already shone a harsh spotlight on the outdated legal definitions governing modern Filipino lives.

The Road Ahead for the Healthcare Decisions

As lawmakers weigh the merits of the Right to Care Act, advocates continue to push for structural clarity. The core issue remains whether the law will finally catch up to the reality of chosen caregivers in hospital emergency rooms. As family structures, domestic partnerships, and caregiving arrangements evolve, policymakers face a dual challenge: determining who holds authority in a hospital room, and deciding whether our current laws adequately protect the relationships that matter most.

While the Right to Care Act represents a massive step forward, comprehensive legal inclusion will require broader legislative reforms including the passage of the anti-discrimination SOGIE Equality Bill—to fully strengthen patient autonomy and protect diverse caregiving practices.

Without these structural changes, many Filipinos will continue to be isolated from the people they trust most during life’s most vulnerable moments, simply because their love falls outside the boundaries of tradition.